Provider Demographics
NPI:1184034035
Name:HILLDRUP, KELLEY MCQUIDDY (DO)
Entity Type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:MCQUIDDY
Last Name:HILLDRUP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MARKET RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3510 ANDERSON HWY STE A
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5846
Practice Address - Country:US
Practice Address - Phone:804-598-3100
Practice Address - Fax:804-598-2965
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine